Kidney Stones

Kidney Stones—Adult

Definition

Kidney stones are pieces of a stone or crystal-like material. These stones form inside the kidneys or other parts of the urinary tract. The kidneys remove waste from the body. They also balance the water and electrolyte content in the blood by filtering salt and water.

Symptoms

In many people, kidney stones do not cause symptoms and pass during urination. Other people may have symptoms, including:

Sharp, stabbing pain in the mid-back that may occur every few minutes and last from 20 minutes to one hour

Pain in the lower abdomen, groin, or genital areas

Nausea and vomiting

Blood in the urine

Frequent urge to urinate

Burning pain during urination

Fever

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Your doctor may recommend further testing to confirm a diagnosis and rule out other conditions. These may include:

Tests to gather information about your urine:

Urinalysis

24-hour urine

Urine culture

Blood tests

Tests to take detailed pictures of your kidneys and urinary system:

X-ray

Spiral CT scan

Ultrasound

Intravenous pyelogram (IVP)

Treatment

Treatment depends on the size and location of the kidney stone. Treatment may include one or more of the following:

Water

For small kidney stones, drinking at least two or three quarts of water a day helps the body pass the stones during urination. The doctor may provide a special cup to catch the stone when it passes so it can be analyzed. If you are having a hard time keeping fluids down, you may need to be hospitalized to receive IV fluids.

Medications

Your doctor may recommend that you take pain medication. You may also be prescribed medications that may help you pass your kidney stones during urination.

Surgery

Surgery may be needed if the stones are:

Very large or growing larger

Causing bleeding or damage to the kidney

Causing infection

Blocking the flow of urine

Unable to pass on its own

Ureteroscopy

Ureteroscopy uses a small camera to locate the stones located in the ureter or kidney. Once found, a small basket is used to capture and remove the stones. Larger stones can be broken up into small pieces with a laser.

Percutaneous nephrolithotomy (PNL)

PNL is used to treat large stones located in the kidney. A small incision is made in the lower back. A nephroscope is passed through a tube so the kidney stones can be seen. The stones are broken in to smaller pieces and removed. A temporary drain may left in the incision site.

Lithotomy

Lithotomy is an open surgery used to remove stones. This is rarely used because of the less invasive options available.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal Shock Wave Lithotripsy (ESWL) uses a device called a lithotripter that is applied to the skin. The lithotripter sends shock waves into the body. The impact of the shock waves breaks up the larger stones so they can be passed during urination.

If you are diagnosed as having kidney stones, follow your doctor's instructions .

Prevention

Once you have formed a kidney stone, you are more likely to form another. Here are some steps to prevent this condition:

Drink plenty of fluids, especially water.

Talk to your doctor about what diet is right for you. Depending on the type of stone you have, you have to avoid certain food or drinks.

Depending on what type of stone you have, certain medicines may be prescribed to keep stones from forming again.